NCLEX-RN
Free NCLEX RN Exam Questions
Extract:
Question 1 of 5
The nurse is admitting a client with folic acid deficiency anemia. Which of the following questions is most important for the nurse to ask the client?
Correct Answer: B
Rationale: Aspirin does not affect folic acid absorption. Folic acid deficiency is strongly associated with alcohol abuse. Because folic acid is a coenzyme for single carbon transfer purines, calves liver or other purines are the meat sources. Folic acid does not affect stool character.
Question 2 of 5
A client with leukemia who has been receiving Trimetrexate (methotrexate) has an order for Wellcovorin (leucovorin). The rationale for administering Wellcovorin is to:
Correct Answer: D
Rationale: Leucovorin (Wellcovorin) is a rescue therapy given after methotrexate to reverse its toxicity and protect healthy cells from damage particularly in bone marrow and mucosal tissues. It does not treat anemia enhance synergy or increase neutrophils.
Question 3 of 5
On the first postpartal day, a client tells the nurse that she has been changing her perineal pads every 1/2 hour because they are saturated with bright red vaginal drainage. When palpating the uterus, the nurse assesses that it is somewhat soft, 1 fingerbreadth above the umbilicus, and midline. The nursing action to be taken is to:
Correct Answer: A
Rationale: Gentle massage and expression of clots will let the fundus return to a state of firmness, allowing the uterus to function as the 'living ligature.' A distended bladder may promote uterine atony; however, after determining the bladder is distended, the nurse would have the client void. Catheterization is only done if normal bladder function has not returned. Oxytocic medications are ordered and administered if the uterus does not remain contracted after gentle massage and determining if the bladder is empty. The client is not complaining of discomfort or pain; therefore, analgesics are not necessary.
Question 4 of 5
The nurse receives report on the group of clients listed here. Place the client list in sequential priority order for the nurse to assess. (Most important for the nurse to assess first, second, third, and fourth.)
Order the Items
Source Container
Correct Answer: C, B, D, A
Rationale: Priority: GCS 5 with aneurysm (
C) is life-threatening, followed by traumatic brain injury (B, potential deterioration), motor vehicle accident with GCS 13 (D, stable but needs monitoring), and migraine (A, non-emergent).
Question 5 of 5
Which finding is the best indication that a client with ineffective airway clearance needs suctioning?
Correct Answer: C
Rationale: Adventitious breath sounds (e.g., rhonchi, wheezing) indicate mucus obstruction, signaling the need for suctioning. Oxygen saturation, respiratory rate, and ABGs are less specific.